[Resolved]  Apollo Munich Health Insurance — Claim Rejection-ref 73298

Address:

Bangalore, Karnataka

Dear Sir,

I had taken Apollo Munich Health Insurance last year March-2012. My Policy No: 120300/11052/[protected] & its covered a sum insurance for my family ( Myself- RIAZ KHAN, My Wife TASNEEM AQSA & My Son REHAN KHAN) upto Rs 7.5 lac & also covered critical illness of each individual of Rs 7.5 lacs.

On Dec-12 I discovered a small (VASCULAR MALFORMATION-VENOUS) on my left thigh & went to visit a Doctor in Manipal Hospital & he advice for an MRI (report enclosed). As I been employed in UB Group, hence decided to go for an operation in Mallya Hospital only and contacted a Vascular Surgeon (Dr.Nagabhushan). He gave a date of 30th January-2013. (Dr Reports enclosed). Then Hospital Insurance representative (Ms.Neha) submitted document for Insurance claim to Apollo Munich & Claim reference No: 73298 on 28th January-13.

Things got worse from there on. The Apollo Munich Representative ( Dr.Yashwant-[protected]) kept rejecting the claim with various reasons. Mallya Hospital representative told that such things are very common these days with Insurance company. Better you get admitted & once we submit the admit reports & all, they will surely clear your claim.

Finally I got admitted on 30th Jan-13 (Thursday) & again hospital people submitted claims but Apollo Munich Representative ( Dr.Yashwant-[protected]) rejected the claim again by asking some more documents. Finally I got operated on 31st Jan-13 & while taking discharge on 1st Feb-13, Mallya Hospital has submitted all relevant documents (Copy Enclosed) in the morning. But Apollo Munich Representative ( Dr.Yashwant-[protected]) kept asking some documents & this exchange of mails continued for another 5 Hrs.

Finally at 4.00PM Mallya Hospital representative inform me about this which is a huge embarrassment for me & my family members. I immediately made a cash payment & took discharges before things get more obnoxious.

Between these exchange of mails I contacted below listed persons of Apollo Munich & ask their cooperation but rather helping me all tried to escape their hand.
1. Saurabh Pandey-[protected]
2. R Yogananda Reddy- [protected]
3. Dr. Yashwant-[protected] (whom I explained many times over phone about my case but always tries to keep sending different queries)

Enclosed:
1. Discharge Summary
2. Bills Copy
3. Dr.Nagabhusan review
4. MRI Report

Request you to look into the matter with deep concern & suggest further action in this regard. Also want a strict action against the representative mention above so that it avoid unnecessary harassment of customer & save your company image. While selling Mediclaim, these representatives knock every corner of doors & when it comes to claim (Especially from Individuals) they turn their backs.

With a copy of this I am marking copy to:
1. USL Admin & HR Dept to inform all individual Insurance holder of Apollo Munich about this incidents
2. Consumer Complaints Forum
3. National Consumer Help Line

Regards
Riaz Khan
UB Group
UB City, 24, Vittal Mallya Road, Bangalore-560001
Mobile: +91-[protected]